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Hospital EHR Adoption Up, But Problems Persist

More hospitals than ever have implemented electronic health records (EHRs), but challenges and the adoption gap have not lessened, according to new research published in Health Affairs.

The study's authors reviewed data from a 2009–2014 American Hospital Association survey. They found that three quarters (75.2 percent) of hospitals have adopted at least a basic EHR system in 2014 –– up from 58.9 percent in 2013 and a continuation of annual double-digit percentage-point progress since 2010. Of those hospitals that hadn't adopted a basic system, many were close to achieving the 10 EHR functionalities that would constitute a basic EHR.

Larger, urban, nonprofit, and major teaching hospitals were more likely to have a comprehensive EHR system. However, many of the hospitals that have not yet adopted an EHR system may be those who face the biggest challenges in doing so. For instance, 32 percent of critical access hospitals have not yet adopted a basic EHR system, compared with 21.9 percent of non-critical access hospitals.

Other challenges reported by hospitals included the startup and ongoing costs of the systems, obtaining physician cooperation, and the complexity of meeting “meaningful use” criteria within the required time frames. While there was roughly a sevenfold increase in the number of hospitals that were ready for stage 2 of meaningful use from 2013 to 2014, that amounted to only 40.5 percent of hospitals.

The researchers suggest that policymakers respond to calls to delay stage 3 of meaningful use and streamline regulations to free resources so hospitals can focus on other priorities, such as transitioning to value-based care. They also recommend addressing the financial challenges as well as the gaps in EHR adoption, which were "persistent."